Treatment of brain and spinal cord cancer

Treatment for brain and spinal cord cancer is given by cancer specialists (oncologists). Some specialize in surgery, some in radiation therapy and others in chemotherapy (drugs). These doctors work with the person with cancer to decide on a treatment plan.

Brain tumours and spinal cord tumours are treated in a similar way.

Treatment plans are designed to meet the unique needs of each person with cancer. Treatment decisions for brain and spinal cord cancer are based on:

type of tumour

grade of tumour

location of tumour

tumour size

neurological (nervous system) function

age of the person

Treatment options for brain and spinal cord cancer

surgery – the main treatment for brain and spinal cord tumours

biopsy

A surgical biopsy is used to determine the type of tumour.

craniotomy

The surgeon opens the skull to remove all or as much of a brain tumour as possible.

Brain mapping is done during a craniotomy when a tumour is near speech or motor areas of the brain. This technique involves stimulating the surface of the brain with an electrical current to determine the function of a particular part of the brain.

external ventricular drain (EVD)

A tube is threaded into the ventricle to allow extra cerebrospinal fluid (CSF) to drain into an external collection system or drainage bag.

shunt placement

A shunt is placed to drain extra cerebrospinal fluid (CSF) and lower intracranial pressure, which can occur when a brain tumour blocks the flow of CSF.

endoscopic third ventriculostomy (ETV)

The surgeon creates an internal bypass so cerebrospinal fluid can flow around an obstruction.

ETV may be used to biopsy or remove tumours within the ventricles.

Ommaya reservoir placement

A device is inserted under the scalp and a catheter is threaded into a ventricle or cyst in the brain.

The Ommaya reservoir can be used to drain extra CSF or to inject chemotherapy drugs.

laminectomy

The surgeon opens a bone of the spine (vertebrae), which covers the spinal cord, to remove a spinal cord tumour.

en bloc resection

The surgeon removes an entire spinal cord tumour in one piece.

stabilization of the spine

The surgeon will use fixation devices, such as special pins, rods and plates, to support and stabilize the spine if it is weakened when part or all of a vertebra is removed.

external beam radiation therapy

Radiation therapy is given when surgery cannot be done.

It may also be used after surgery to:

treat tumours that could not be completely removed

destroy cancer cells left behind

Radiation is used to treat recurrent brain tumours.

chemotherapy

Chemotherapy is given after surgery or radiation therapy.

It may also be used with radiation therapy to improve the effect of radiation.

biological therapy

Biological therapy is used to treat some recurrent brain tumours.

active surveillance

Active surveillance may be a treatment option for some types of low-grade tumours.

The chance of brain and spinal cord cancer recurring is greatest within the first several years after therapy, so close follow-up is needed during this time.

Because a tumour can recur many years after initial treatment, long-term follow-up care is very important.

There are different treatment options for brain metastases (cancer that has spread to the brain from other organs) and bone metastases (cancer that has spread to the bones of the spine from other organs).

Clinical trials

Clinical trials investigate new and better ways to prevent, detect and treat cancer. There are some clinical trials in Canada that are open to people with brain and spinal cord cancer. For more information, go to clinical trials.